Physicians In Primary Health Care Centers Research Articles

Physicians' Practices in Diabetic Nephropathy in Primary Healthcare Centers in Jazan City, Saudi Arabia, 2023.

Background and Objectives: Diabetes is one of the most common diseases dealt with by physicians in primary healthcare centers (PHCs). The disease is associated with macrovascular and microvascular complications, especially in those with long disease duration and uncontrolled diabetic nephropathy, which is one of the most common microvascular complications among diabetic patients. This investigation assessed the practices of physicians working at PHCs in terms of diabetic nephropathy screening, management, and referral. Materials and Methods: This study is a cross-sectional investigation targeting physicians working at PHCs in the Jazan region of Saudi Arabia between March and August of 2023. Data were collected via a self-administered questionnaire, which was distributed via online platforms. The questionnaire included sections measuring physicians' demographic data and associated factors regarding training, the availability of resources, and practices in diabetic nephropathy, including screening, management, and referral. Chi-squared tests were used to assess associations between the practices of physicians and the measured demographics. Result: A total of 234 physicians participated in the investigation. The median age of the participants was 35 years. The adherence level of practice toward diabetic nephropathy according to American Diabetes Association (ADA) guidelines ranged from 40 points (the highest adherence level of participants) to 19 points (the lowest adherence level of participants), with a median of 33 points. Higher adherence levels were noted among physicians in Saudi Arabia, physicians with higher education levels, physicians specializing as family physicians or diabetologists, physicians who reported attending online and on-site training at diabetic centers, physicians who reported continuous access to urine and serum creatinine tests, and physicians who reported continuous access to the American Diabetes Association guidelines (p < 0.05). Conclusions: There are several factors associated with the level of adherence in diabetic nephropathy practice, such as physicians' education level, specialty, training, and access to guidelines. The findings suggest the need for more training for PHC physicians in the care of patients affected by or at risk of diabetic nephropathy.

Primary Health Care Physicians Perceptions about Centralized Electronic Prescription Service in Qassim Province, Saudi Arabia

Introduction: In the current era, electronic prescriptions are increasing in developed countries including Saudi Arabia, where the resources were adequate to manage the manpower and technical issues. The objective of the study was to find the perceptions of the physicians about the centralized electronic prescriptions at the primary health care centers (PHCCs) and suggestions to improve the existing service. Methodology: A cross-sectional study was carried out among the PHC physicians and distributed questionnaires to 200 physicians through Google Links. Based on the WhatsApp group numbers, circulated a questionnaire to entire Qassim PHCC physicians and 131 physicians responded to our survey. Data were entered and analyzed with SPSS 21.0 version and necessary statistical tests were applied. Results: In the current study, 70.2% (n-92) were males and 40.5% (n-53) were 25–35 years of age. About 91.6% (n-120) of physicians gave an opinion of average and above satisfaction regarding Wasfaty service. Approximately, one-fifth of physicians (20.6%, n-27) gave their opinion as did not face difficulty with Wasfaty service. Approximately, half of the physicians (53.4%, n-70) gave a response as the Wasfaty service did not reduce the waiting time for the patient. There was significant association was observed among physicians fully satisfied with increasing prescription time and age (p < 0.05). One-third, 34.8% (n-55) of physicians gave an opinion on an internet problem, and 26.6% (n-42) physicians mentioned more options of medication at Wasfaty service. Conclusions: Based on the results of the study, PHCC physicians’ satisfaction regarding the Wasfaty service was good. But, need to address certain modifiable issues like internet problems, and more options for medication availability at Wasfaty service. Need similar studies as a follow-up survey are required to substantiate the current study findings and to improve Wasfaty service satisfaction.

Tip 2 diyabet ve atriyal fibrilasyon geçici iskemik atağa neden olabilir

Diabetes mellitus (DM) is still one of the common chronic problems not only in rural but also the urban cities. While the regulation of blood sugar metabolism is one of the target points, living with DM can trammel primary care physicians. &#x0D; 64 years old female patient who was diagnosed with DM and hypertension for at least 5 years has attended the surgery for nuisance and dysuria. Bacteriuria has detected and blood sugar was 550 mg/dl WBC= 12,48 CRP: 7 HbA1C: 10,4 % Her neurologic examination was normal except she has got urinary incontinence. She was hospitalized with a diagnosis of DM, HT, and cystitis. Metformin 2x1gr, 1x 40 mg, ceftriaxone 2x1gr, and insulin glargine were ordered. Diabetic patient education has been performed. During follow-up, her blood sugar regulation has been settled but she complained of palpitation, ECG has been performed and diagnosed as AF (atrial fibrillation). Her blood pressure was 120/80 and metoprolol infusion was made. INR: 1,44 sec PT=17sn creatine=0,9 mg/dl. Control ECG was at sinus rhythm. While she was in time of recovery, internal medicine consultation has performed and she was planned to discharge. She complained about "could not talk". In her neurologic examination, her left arm has lost strength (3/5) and she could hear and understand what was told but couldn't speak. She was transferred to another health center for detection and treatment as pre-diagnose of Transient Ischemic Attack (TIA). &#x0D; DM never walks alone. At primary health care centers physicians should be aware of chronic conditions as well as the new onset problems to manage.

Primary health care centers Physicians’ satisfaction toward COVID-19 management in Asser Region, Saudi Arabia

Background. The presence of extensive workload and pressure associated with COVID19 has resulted in a lot of mental and physical trauma in primary health care physicians (PHCC) across the world. Aim of the study. The present study is aimed at understanding the level of dissatisfaction in PHCC physicians in the Asser region of Saudi Arabia. The various risk factors associated with dissatisfaction also have been analyzed in this study. Method. An analytical cross-sectional study was performed on various PHCCs who were working in the Ministry of Health in the Asser region. Results. The overall analysis showed that around 73% of the physicians who responded showed dissatisfaction. The major factors that were found to affect satisfaction based on the variables analyzed include physicians who are males, Saudi Nationals, training residents, and those who received recognition. These four variables had a p value of less than 0.0001 making it statistically significant. Conclusion. The study observed that there is dissatisfaction amongst PHCC physicians towards the management of pandemics. The factors identified should help officials in order to address these issues

Assessing Physical Activity and Perceived Barriers Among Physicians in Primary Healthcare in Makkah City, Saudi Arabia.

IntroductionAdvocating a healthy lifestyle is the cornerstone of primary healthcare physicians. As physicians are the ultimate role models for patients regarding health and well-being, we focused on physicians working in primary healthcare centers (PHCs) in Makkah because they work on the frontline of disease prevention and are considered the first point of contact for patients entering the health system. This study aimed to estimate the physical activity levels in physicians working in the PHCs of Makkah and any perceived barriers to engage in physical activity.MethodologyWe conducted a cross-sectional study at PHCs in Makkah from October 2021 to December 2021. We used a multistage cluster random sampling technique to select primary healthcare physicians in Makkah city. We recruited 196 physicians working in PHCs for this study. We used the short version of the International Physical Activity Questionnaire to measure physical activity levels, and we used the barriers to being active questionnaire to identify the barriers. Descriptive analysis was performed using frequencies. Bivariate associations between the most frequently reported barriers and sociodemographic variables were determined using the chi-square test, Student t-test, and analysis of variance via IBM SPSS Statistics for Windows, version 22.0 (Armonk, NY: IBM Corp.).ResultsApproximately 45.9% of physicians were overweight, while 69.4% were not gym members. In the seven days prior to answering the surveys, approximately 71.9% did not report any vigorous activity, and 30.6% had performed moderate activity. The most significant barrier to being active was a lack of time (70.9%), followed by a lack of resources (69.9%). In bivariate analysis, we noted a significant negative relationship between gym membership, vigorous and moderate physical activity, and perceived barriers scores (p<0.001).ConclusionMost of the physicians in PHCs are not physically active. The main barrier to their physical activity is lack of time. There is a need to encourage them and motivate them to be physically active to model more healthy behaviors to the general population.

Barriers facing family physician in primary health care when dealing with emergency cases in Riyadh, Saudi Arabia.

The scarcity of emergency cases presented to the primary health care centers (PHCCs) makes treating such cases by family physicians more difficult To identify the barriers facing family physicians in PHCCs when facing emergency cases in Riyadh, Saudi Arabia. A cross-sectional descriptive design was deployed in the study among a sample of family physicians. A reliable and valid self-reported questionnaire was used. In addition, an observational sheet was used to investigate the preparedness of PHCCs to deal with emergency situations. The study included 162 PHC physicians. Almost two-thirds of them (65.4%) aged 25-34 years, and 52.5% were females. Middle-aged (25--35 years) physicians (P = 0.030), females (P < 0.001), Saudis (P = 0.027), those attended advanced cardiovascular life support (ACLS) since more than 2 years (P = 0.029), those who had no exposure in working in emergency units (P = 0.029), and less experienced physicians (<1 year) (P = 0.010) showed lower "perceived level of competence in performing emergency skills." The commonest barrier facing physicians during the management of emergency cases in thePHC was lack of appropriate equipment (76.5%), followed by lack of exposure to emergency cases (62.3%) and lack of time (50.6%). Dealing with emergency cases is considered part of the medical practice in PHCCs. For primary care physicians, the level of training in emergency medicine courses is suboptimal particularly advanced trauma life support (ATLS) courses in Riyadh. Inregards to emergency services at the PHC level in Riyadh, most of the items were available; however, defects were reported in some. Knowing the barriers facing doctors during dealing with emergency cases helps in improving and providing integrated medical care.

A Study of the Attitudes towards Mentally Ill People among a Sample of Primary Health Care Physicians in Saudi Arabia

Background: Psychiatric illnesses are a public health problem worldwide, affecting people of all age. Mental health is an important sector of primary health care services. An increasing number of Saudi citizens and residents utilize primary healthcare services for mental health concerns; hence, there is a need to objectively assess these doctors' attitudes towards people with mental illness.&#x0D; Objectives: Assessment of the attitudes toward mentally ill people among a sample of primary health care physicians in Saudi Arabia &amp; determination of risk factors associated with bad attitudes.&#x0D; Methods: A cross-sectional study was conducted over a period of 30 days (1st September 2021 to 30 September 2021). The study has been conducted on Convenient Sample of Arabic speaking physicians working in primary health care centers in Saudi Arabia who accepted to share in research. Demographic Data was gathered using an electronic self‑administered questionnaire and physicians’ attitudes towards mentally ill people have been evaluated by an Arabic previously validated Questionnaire.&#x0D; Results: This study included 214 physicians, 114 male physicians and 100 females. 72% of participants have a highly positive attitude toward mentally ill patients with a mean score (50±4) and only 28% of participants have a negative attitude with a mean score (38±4). Better attitudes were significantly associated with being female, having (Board, PhD or Fellowship), working for less than a year and having a history of involvement in the care of a mentally ill person. There were no statistically significant differences regarding participants age, nationality, marital status, place and mode of residency, specialty, and having current or past history of mental illness.&#x0D; Conclusions: Primary health care physicians in Saudi Arabia have positive attitudes toward mentally ill patients, female physicians , having (Board, PhD or Fellowship), working for less than a year and having a history of involvement in the care of a mentally ill person were significantly associated with better attitudes.&#x0D; Recommendations: Further larger studies are needed on large number of primary health care centers physicians in Saudi Arabia and other Arab countries. Additional research and programmatic work are needed to understand the reasons for negative attitudes. Effective teaching and training programs is necessary to bring in positive attitude change towards mentally ill people among primary health care physicians.

Awareness about the New Social Health Insurance System, among Physicians in Primary Health Care Centers in Cairo governorate, and Factors Affecting it

Abstract Introduction The Government of Egypt is committed to attain Universal Health Coverage (UHC), and its progress in this vein has been spurred recently through the approval of the Social Health Insurance (SHI) law. Health providers are important stakeholders in the implementation of the SHI system. Objective The objective of this study was to estimate the level of awareness of physicians and managers in Primary Health Care Centers (PHCCs) in Cairo governorate about the new system and the factors affecting it. Method A cross-sectional study was conducted to estimate the awareness level of 100 physicians and managers from PHCCs in Cairo governorate in 2019. PHCCs subjected to this study were selected randomly from the official list of the PHCCs in Cairo governorate from the MOH, and the required sample of physicians was randomly selected inside each center. A semi-structured Arabic interview questionnaire was used, with a reliability coefficient of 0.70. Results The study revealed that the respondents’ awareness level of the new SHI System was mostly average (78% between Q1-Q3 of the total awareness score). Only 54% of the participants considered themselves aware of the new SHI system. 82% of the respondents expressed their desire to get more information about the new SHI system. The majority of participants (88%) reported that they did not attend any induction or training courses regarding the SHI system. Only 4% of the respondents stated that they are fully and clearly aware of their role in the new SHI system. Managers and older participants showed significantly higher means of awareness than the competitors groups. Conclusion The study concluded that the level of awareness about the SHI among the studied sample of the PHCCs physicians at Cairo governorate was averaged. Recommendation: Efforts should be enhanced for reaching out to the physicians in PHCCs, including those working in governorates where implementation of SHI system hasn’t commenced yet, especially to emphasize their understanding of the objectives and elements of the new system.

S3250 Knowledge, Attitude and Obstacles of Colorectal Cancer Screening in Primary Health Care in Bali, Indonesia

Introduction: The incidence of colorectal cancer (CRC) in Indonesia is rising. Screening is an essential effort for Early diagnosis of cancers, and was done mainly at primary health care centers (PHCs) by primary care physicians (PCPs). We aimed to evaluate the knowledge and attitudes of PHC provider regarding CRC screening and identify the obstacles associated with the screening plan. Methods: A cross-sectional study was conducted among PHC physicians and nurses in public primary health care centers in Bali, Indonesia. A 44-item self-administered questionnaire was used to assess the knowledge, attitude and obstacle practice of CRC screening. All respondence signed the informed concern electronically before participating in this study. Results: Two hundred and five respondents have participated in this study. The range of Age was 20- 55 year. 60% female, and the rest were males. 63.9% are PCPs, and 36.1% are nurses. The average duration of doing practice in PHC is 6.6 years. In knowledge of CRC, 50.2% of them have good knowledge, and there is no difference between PCPs vs nurses (51.9% vs 47.3%; P = 0.53). In attitude toward CRC screening, 58.5% out of the have good attitude, and there is no difference between PCPs vs nurses (60.3% vs 55.4%; P = 0.50). The obstacle of the screening was divided into two areas, a barrier from the health care system and patients. Cost of screening (95%) and lack of health care facilities (85%) as the main reason for the health care system obstacle. And Fear to know they have a cancer as a main reason from patients’ aspect (90%). There is no association between knowledge and attitude towards CRC screening (P = 0.63). Conclusion: In this study, Both of PCP and nurses has inadequate knowledge of CRC screening and only half of them has a good attitude toward CRC screening, because there is no national population-based screening program in Indonesia. There is no association between knowledge and attitude, because they did not translate their knowledge to daily practice. This condition also related to the lack of CRC screening facilities in PHC and high cost. Lack of knowledge from people in the population suggest need a big effort to reduce the barrier from health care system and population to reach success in CRC screening program as a conclusion, Knowledge and attitude of PCPs and nurses in the practice of CRC screening were inadequate. Lack of facilities, cost of screening and lack of knowledge as main barrier for screening.

Evaluation of Knowledge and Adherence of Primary Healthcare Physicians Regarding Hypertension Prevention Guidelines in the Jazan Region, Saudi Arabia.

Introduction:Adherence to hypertension prevention guidelines can aid in better control of blood pressure.Aim:This study aims to evaluate knowledge and adherence of Primary Healthcare Centers (PHCs) physicians in the Jazan region, Saudi Arabia about guidelines pertaining to prevention of hypertension.Methods:This cross-sectional study targeted PHCs physicians in the Jazan region. A questionnaire was developed based on preventive components of the Saudi Hypertension Management Guidelines (SHMGs) and was completed via interviews to measure demographics, knowledge of PHCs’ physicians about prevention of hypertension, and their adherence to guidelines concerning screening for hypertension and provision of lifestyle counselling.Results:A total of 234 PHC physicians participated in this investigation. The median age of the physicians was 38 and percentages of male and female physicians were similar. The findings suggest a low level of knowledge and practice adherence concerning prevention of hypertension among PHCs physicians in Jazan region where only 24 physicians (10%) knew the recommended amount of daily sodium intake to reduce blood pressure among pre-hypertensive patients. Similarly, only 30 physicians (13%) reported adherence to the SHMGs concerning annual screening for the disease. None of the associations concerning influence of physicians demographics on level of knowledge or practice adherence were statistically significant (P value >0.05).Conclusion:The majority of the recruited physicians were misinformed about several components related to screening for hypertension and dietary needs for lowering blood pressure levels. The low knowledge may explain the low adherence to recommended SHMGs for prevention of the disease.

Assessment of the Consultation Rate with General Practitioners in the Initial Phase of the COVID-19 Pandemic.

Background: The COVID-19 pandemic affected the functioning of healthcare systems (HSs) in a way that was difficult to foresee earlier. It quickened the introduction of e-medicine, and changed the manner and number of services provided in the open medical setting. Aim: To assess variations in the consultation rate of patients in primary healthcare centers (PHCs) in consecutive months of the pandemic. Method: Data collected from two PHCs located in Olsztyn (Poland) were analyzed retrospectively. Collectively, these two centers provide care for approximately 20,000 inhabitants and perform approximately 100,000 medical services annually. The analysis was based on data covering the period April–July of the years 2010–2020, consisting in total of 337,510 medical services records. Results: A large, statistically significant decrease in the consultation rate (consultation rate understood as the number of individuals seeking consultation in relation to the number of people under care in a given time period) was revealed in each age group in the initial phase of the pandemic. In consecutive months, the approximated consultation rate achieved mean long-term values. Conclusions. The largest reduction in the consultation rate was revealed in the youngest age group, with the smallest occurring in the oldest. In the group of patients older than 65 years of age, the consultation rate after 3 months of the pandemic was the same as before the outbreak. Variations in the consultation rate were independent of the epidemiological situation. During the study, we observed an increased level of the administrative and paperwork activities carried out by PHC physicians.

National Survey about awareness of Primary Immunodeficiency Disorders among Primary Care Physicians in Saudi Arabia: Protocol and Challenges.

Introduction:Primary Health Care Centers (PHCC) are the first contact health facility to which patients in Saudi Arabia can go to seek help. Primary Immunodeficiency Disorders (PIDD) are of various types and severities, and they are associated with a delay in diagnosis. Early diagnosis of PIDD helps to improve the quality of life of affected children and prevent permanent consequences such as organ damage and disability. In this study, we present a protocol of a national survey that assesses awareness among PHCC physicians about diagnosing PIDD and the challenges associated with the execution of this protocol.Methods:This cross-sectional survey used stratified multistage sampling and systematic random selection of PHCC from a list of PHCC affiliated centers under the Ministry of Health (MOH) in Saudi Arabia. The survey was conducted through phone calls to the selected physicians. Data collection started in April 2020, and it is still ongoing.Conclusion:In Saudi Arabia, this study will provide baseline data about PHCC physicians’ levels of awareness of the diagnosis of PIDD. This will help policy-makers in designing educational courses or programs to increase awareness levels among physicians. The protocol could be used to study other health outcomes at a national level.

The role of primary healthcare physicians in violence against Women intervention program in Indonesia

BackgroundViolence against women (VAW) has many impacts on health, but the role of the primary healthcare physicians in the intervention program is lacking. This research aimed to explore the primary healthcare physician role in a comprehensive intervention program of VAW in Malang City, Indonesia.MethodsThis qualitative research was conducted using a phenomenology approach. A focused group discussion followed by in-depth interviews were carried out involving six primary healthcare physicians in Puskesmas (Primary Healthcare Center) and two stakeholders. Legal document related to VAW was reviewed to measure up the role of the primary healthcare physicians.ResultOur study revealed that the role of physicians in primary healthcare centers on the VAW intervention program was limited. This was due to the insufficient knowledge of the physicians on the VAW program, physicians’ constraint on counseling skill, unsupportive infrastructure, and a limited number of physicians in Puskesmas. Some barriers related to the VAW program management were also discovered and needed intervention at the decision-maker level.ConclusionThe role of primary healthcare physicians in the comprehensive intervention of the VAW program is not optimum. The source of the problem involves the physician capability and program management aspects in all levels of decision-makers. Local government awareness and commitment are needed to improve the overall management of the VAW intervention program in this city.

Family Physicians' Approaches to Mental Health Care and Collaboration with Psychiatrists.

ObjectiveThis study aimed to determine the proportion of family physicians referring patients to psychiatrists and conducting psychotherapy or mental health consultations themselves. Additionally, the factors affecting family physicians’ approaches to dealing with mental health patients were investigated, including referrals to psychiatrists and physicians’ views about better management plans for patients with mental health disorders.MethodIn this cross-sectional observational study, online surveys were distributed, using Google forms, to family physicians in primary healthcare centers and hospitals in Jeddah, Saudi Arabia. The participants were 175 family physicians. A previously developed survey under the name "collaboration between psychologists and primary health care physicians" was adapted to suit the purposes of the present study, by changing the aim of the survey from psychologists to family physicians.ResultsPhysicians who received inter-professional training in a clinical training program were more likely to agree that their education prepared them well for collaboration with psychiatrists, compared to those who did not receive such an education (p<0.001). The younger and less experienced physicians were more likely to carry out psychotherapy and mental health consultations by themselves more often than were the more experienced physicians (33.1% versus 9.7%; p<0.001), it has also been shown that almost 90% of physicians agreed that collaboration with psychiatrists is necessary for the care of their patients, and only a third responded that psychiatrists were accessible if and when they want to consult with them.ConclusionsFamily and primary care physicians must collaborate with psychiatric professionals in order to provide effective services. Moreover, family physicians should receive more education about mental health, and effective communication should be encouraged in order to deliver better care to psychiatric patients in primary healthcare settings.

Erratum.

Pekçetin, S., Salar, S., İnal, Ö., & Kayıhan, H. (2018). Validity of the Turkish Occupational Self Assessment for Elderly Individuals. Occupation, Participation and Health, 38, 105-112. DOI: 10.1177/1539449217743457 On page 106 of the above-mentioned article, the institutional details were removed at two instances and left as "removed for blinding purposes." The updated correct sentences are: Ethical approval was obtained from the Trakya University Scientific Research Ethics Committee prior to the study. Written informed consent was obtained from all the participants. This study was carried out at Primary Health Care Centers (PHCC) in Edirne, Turkey. PHCC physicians were informed about the study and requested to direct nondisabled individuals over 65 years of age to the researchers after their health services were completed.

Erratum.

Pekçetin, S., Salar, S., İnal, Ö., & Kayıhan, H. (2018). Validity of the Turkish Occupational Self Assessment for Elderly Individuals. Occupation, Participation and Health, 38, 105-112. On page 106 of the above-mentioned article, the institutional details were removed at two instances and left as "removed for blinding purposes." The updated correct sentences are: Ethical approval was obtained from the Trakya University Scientific Research Ethics Committee prior to the study. Written informed consent was obtained from all the participants. This study was carried out at Primary Health Care Centers (PHCC) in Edirne, Turkey. PHCC physicians were informed about the study and requested to direct nondisabled individuals over 65 years of age to the researchers after their health services were completed.

Implementation of an early rheumatoid athritis unit for the early recognition and treatment of the disease

Early recognition of rheumatoid arthritis (RA) provides clinical benefits in terms of remission induction, reduced disease progression, and eventually treatment free remission. To describe the setting of a Unit devoted exclusively to the recognition and treatment of early RA in patients referred from primary healthcare centers (PHC) in Chile. Patients were referred from nine participating PHC from 2014 through 2016. PHC physicians received a formal training to enhance criteria recognition and program adherence. Mandatory referral criteria were an age above 17 years, and arthralgia of less than 1-year duration, plus at least one of the following: morning stiffness of more than 30 minutes, swelling involving more than 3 joints for more than 1 month, a positive squeeze test or abnormal inflammatory serum markers. One hundred twenty patients aged 45 ± 12 years (90% women) were assessed at the early rheumatoid arthritis unit. Median time to referral from PHC to the Unit was 14.6 days. The median duration of symptoms for the overall sample of patients was 10.8 months. RA was identified in 43 patients (36%), with a delay between onset of symptoms and diagnosis of 8.3 months. Regarding the performance of referral criteria, the most sensitive was morning stiffness (80%, sensitivity 95% confidence intervals (CI) 64-89%) and synovitis was the most specific (specificity 83%, 95% CI 72-90%). The positive predictive value of the three clinical criteria altogether was 68.1% (95% CI 47-83%). Institution of an early RA unit was feasible within the Chilean healthcare system enabling the identification of early RA in one-third of patients.

Knowledge and attitude of pediatric hearing impairment among general physicians and medical interns in coastal Karnataka, India

Objective: The objectives of the present study were to investigate and compare the knowledge and attitude among general physicians in primary health-care centers and medical interns. Materials and Methods: A questionnaire-based observational study design was implemented to assess and compare the knowledge and attitude of physicians and medical interns regarding pediatric hearing impairment in setups that have speech and hearing services and that do not offer these services. Results: The general physicians and medical interns showed a positive attitude toward different issues such as importance of hearing in development of speech and language, importance of hearing as a sense, need of hearing screening in newborns, consideration of suspicion of hearing loss by parents, and need of speech therapy. Conclusion: Even though the participants showed adequate knowledge and attitude toward pediatric hearing impairment, there are certain areas that need attention and awareness development. There is also a need to introduce speech and hearing settings at all hospitals as this will ensure a better awareness about the role of the professionals and enable more referrals.

Knowledge, attitude, and practice among primary health-care physicians toward smoking cessation in Makkah, Saudi Arabia

Background: Tobacco smoking is one of the main preventable reasons for death on the planet and is a noteworthy general well-being issue in both developed and developing nations. The primary health-care (PHC) doctors speak to an imperative resource in the battle against smoking. Objective: To detect the prevalence of smoking, smoking-cessation knowledge, and attitude among physicians in PHC centers in Makkah and evaluate the smoking-cessation counseling practices of these physicians. Materials and Methods: A cross-sectional study was conducted at 80 PHC centers in Makkah over a period of 2 months. Data were collected by a validated self-administered questionnaire “Global Health Professional Survey” that was adopted from the WHO. Result: The study included 262 PHC physicians. The prevalence of daily current smoking was (18.7%), while male and female prevalences were 26.7% and 1.2%, respectively. Only (7.3%) were occasional smokers. Majority of ever-smoked physicians reported thinking of quitting smoking. Incorrect knowledge was reported among 25.6% of physicians. Logistic regression revealed that physicians of experience ranged between 2 and 10 years were less likely to express incorrect smoking-related knowledge compared with those with an experience of 1 year or less. Current smokers have approximately four-fold risk for incorrect smoking-related knowledge compared with nonsmokers [adjusted odds ratio (AOR) = 4.04; 95% CI: 2.21–7.36]. Negative attitude was reported among 26.2% of physicians. Logistic regression revealed that physicians aged between 36 and 45 years showed a significant negative attitude toward smoking compared with those in the age group 25–35 years (AOR = 5.83; 95% CI: 2.88–11.79). Bad practice regarding smoking cessation was reported among 52.7% of the physicians. Logistic regression revealed that physicians with longer experience of working in PHC centers were significantly less likely to show bad practice regarding smoking cessation compared with those with an experience of 1 year or less. When compared with residents, senior registrars were less likely to exhibit bad practice regarding smoking cessation (AOR = 0.19; 95% CI: 0.05–0.69). Conclusion: The prevalence of smoking among PHC physicians in Makkah was relatively high. Current smokers either occasionally or daily are more likely to show incorrect smoking-related knowledge compared with nonsmokers. Most of PHC physicians showed positive attitudes toward smoking cessation activities, with no significant difference between current smokers and nonsmokers. Almost a 25% of primary health-care physicians did not receive sufficient training in smoking cessation activities.

Barriers Facing Primary Health Care Physicians When Dealing with Emergency Cases in Jeddah, Saudi Arabia.

Objectives:To estimate the prevalence of emergency cases reporting to Primary Health Care centers (PHC), Jeddah, Saudi Arabia and to explore the barriers facing PHC physicians when dealing with such emergency cases.Methods:A cross-sectional analytic study, where all physicians working in the PHC of the Ministry of Health (MOH) in Jeddah; were invited to participate (n=247). The study period was from July 2013 till December 2013. Data were collected through two sources. 1- A self-administered questionnaire used to determine the physicians’ perceived competence when dealing with emergency cases. 2- A structured observation sheet used to evaluate availability of equipment, drugs, ambulances and other supporting facilities required to deal with emergency cases.Results:The response rate was 83.4%. The physicians’ age ranged between 25 and 60 years with a mean ±SD of 34.4±7.5 years. Majority of them (83.5%) did not attend ATLS courses at all whereas 60.7% never attended ACLS courses. The majority (97.1%) had however attended BLS courses. Physicians in the age group 36-45 years, non-Saudi, those who had SBFM, those who reported experience in working in emergency departments and physicians who reported more working years in PHCCs (>5 years) had a significant higher score of perceived level of competence in performing emergency skill scale than others (P<0.05). The prevalence of emergency cases attending PHC in Jeddah (2013) was 5.2%.Conclusion:Emergency services at PHC in Jeddah are functioning reasonably well, but require fine tuning of services and an upgrade in their quality.